Neuromyelitis OpticaPhase 1/2SCT-NMONCT01339455
Autologous Hematopoietic Stem Cell Transplant in Neuromyelitis Optica
A Phase 1/2 study testing AHSCT in people with Neuromyelitis Optica, run by University of Calgary at 1 site in Canada.
Trial summary
Neuromyelitis Optica (NMO) is a demyelinating and degenerative disorder of the CNS affecting vision and spinal cord function. This disease is rare compared to Multiple Sclerosis (MS), but it is devastating and often leads to accumulating disability with a 5 year-mortality of approximately 30%. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Neuromyelitis Optica
- What is being tested?
- AHSCT
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3 participants
- Where
- 1 siteCanada
- Study dates
- Mar 2011to Mar 2017
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age between 18-65, inclusive
- Diagnosis of NMO using Wingerchuk 2006 NMO Criteria
- EDSS 0-6.5
- Treatment with a minimum of one NMO therapy in past 12 months
- One objective and documented relapse in the past 12 months and two relapse events in the past 24 months despite medical therapy
- ECOG performance status 0-3
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- Platelets ≥100 x 109/L
- ALT ≤3 x ULN
- Total bilirubin ≤2.0 x ULN, except in patients with Gilbert syndrome or in patients in whom the bilirubin rise is of non-hepatic origin
- Serum creatinine <1.5 x ULN or creatinine clearance ≥50 cc/min
- Patients must reside in Alberta, Canada for the duration of the transplant period of the trial
Who cannot join
- Any illness that would jeopardize the ability of the patient to complete study protocol
- Prior malignancy unless non-melanoma skin cancer, carcinoma in-situ of the cervix (CIN) or breast, or malignancy treated more than 5 years previously with no evidence of recurrent disease since initial treatment
- Pregnant or lactating females. Women of childbearing potential must have a negative serum or urine β-hCG pregnancy test at screening
- Inability or unwillingness to pursue effective means of birth control
- FEV1/FVC < 50% of predicted
- DLCO < 50% of predicted
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- Resting LVEF < 50 %
- Known hypersensitivity to mouse, rabbit, or E. Coli derived proteins, or to iron compounds/medications
- Presence of metallic objects implanted in the body that would preclude the ability of the patient to safely have MRI exams
- Unable or unwilling to provide written informed consent for participation
- Active infection except asymptomatic bacteriuria
- Any use of investigational therapies within 4 weeks prior to initiation of study treatment
- Patients dependent on prednisone who cannot be successfully tapered to a maximum of 0.5mg/kg/d prior to mobilization therapy
Trial locations and contacts
1 site in 1 country.
Canada1 site
Foothills Medical Centre, University of Calgary
Calgary, Alberta, T2N 2T9
About this study
Official title: Autologous Hematopoietic Stem Cell Transplant in Patients With Neuromyelitis Optica
Neuromyelitis Optica (NMO) is a demyelinating and degenerative disorder of the CNS affecting vision and spinal cord function. This disease is rare compared to Multiple Sclerosis (MS), but it is devastating and often leads to accumulating disability with a 5 year-mortality of approximately 30%. Survivors are typically left with severe morbidity secondary to blindness, quadriparesis and respiratory failure. No agent has been found to be highly effective in halting disease activity. Based on recent outcomes of stem cell transplant trials and reports in autoimmune diseases including MS, and based on the mechanisms of NMO, we anticipate that stem cell transplantation may provide lasting disease stability for NMO patients. The hypothesis of the present trial is that autologous hematopoetic stem cell transplantation in patients with NMO will provide lasting benefit in relapse prevention. Specifically, we anticipate a 50% reduction in the proportion of patients experiencing relapse over a three year period. We will be following patients for a total of five years after transplantation.
Read the detailed description
Patients who are deemed eligible will be enrolled and undergo a two stage transplant process followed by neurological assessments every 6 months for the following 5 years assessing EDSS, visual metrics, MRI, AQP-4 antibodies, MSFC and SF36.
- Conditions
- Neuromyelitis Optica
- Being tested
- AHSCT
- Keywords
- Neuromyelitis Optica, NMO, Devic's Disease, Stem Cell Transplant
- Medical subject headings
- Neuromyelitis Optica
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AHSCTProcedure or surgery
AHSCT Procedure:
- Mobilization and Harvesting:
- Cyclophosphamide
- Rituximab
- GSCF
- Dexamethasone
- Apheresis
- Conditioning and Infusion (3-4 weeks after Mobilization and Harvesting):
- Cyclophosphamide
- MESNA
- Rabbit ATG
- Rituximab
- Methylprednisolone
- Stem Cell infusion
- GSCF
| Study group | Role | What they receive |
|---|---|---|
| AHSCT | Experimental | All patients undergo autologous hematopoietic stem cell transplantation in a two stage process. Receives: Procedure: AHSCT |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion relapse-free at three years
The proportion of surviving patients who are relapse-free at three years after transplant
Measured: 3 years
Secondary outcomes (9)
Proportion relapse-free at five years
The proportion of surviving patients relapse-free at year five
Measured: 5 years
Relapse count
Number of NMO relapse events
Measured: Annually over 5 years
Disability progression
Time to progression of EDSS by one step
Measured: Over 5 years
Retinal nerve fiber layer (RFNL) status
Change in RNFL by optical coherence tomography over trial
Measured: 5 years
25 foot timed walk test
Change in 25 ft timed walk test over trial
Measured: 5 years
PASAT
Annual and change from baseline to end of trial in Paced Auditory Serial Addition Test to assess cognitive function.
Measured: Annually over 5 years
Hospitalization
Number of hospitalizations, days in hospital over trial period
Measured: Over 5 years
Overall survival
Survival over trial period
Measured: Over 5 years
Time to next relapse
Time to next relapse after transplant
Measured: Over 5 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Apr 2011 (estimated)
- Study startMar 2011
- Primary completionMar 2017
- Study completionMar 2017
Why it stopped: recruitment failure
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Neuromyelitis OpticaStudies of the same condition, open and under way.
- More trials run by University of CalgaryThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 3 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Calgary
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jodie Burton MD, MSc, FRCPC, University of Calgary
- Investigators
- Jodie M Burton, MD,MSc,FRCPC, Principal investigator, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of CalgaryJan Storek, MD,PhD, Principal investigator, Department of Medicine, University of Calgary
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01339455
- Sponsor's protocol ID
- CHREB ID# 23282
- Acronym
- SCT-NMO
- Status last verified
- Apr 2018
- First submitted
- 18 Apr 2011
- Last updated
- 2 May 2018
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 2 May 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Autologous Hematopoietic Stem Cell Transplant in Patients With Neuromyelitis Optica
- ClinicalTrials.gov ID
- NCT01339455
- Acronym / sponsor ID
- SCT-NMO / CHREB ID# 23282
- Conditions
- Neuromyelitis Optica
- Keywords
- Neuromyelitis Optica, NMO, Devic's Disease, Stem Cell Transplant
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: recruitment failure
- Enrolment
- 3 participants (actual)
- Lead sponsor
- University of CalgaryUniversity, hospital or other
- Study start
- Mar 2011
- Primary completion
- Mar 2017 (actual)
- Study completion
- Mar 2017 (actual)
- First posted
- 20 Apr 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Neuromyelitis Optica (NMO) is a demyelinating and degenerative disorder of the CNS affecting vision and spinal cord function. This disease is rare compared to Multiple Sclerosis (MS), but it is devastating and often leads to accumulating disability with a 5 year-mortality of approximately 30%. Survivors are typically left with severe morbidity secondary to blindness, quadriparesis and respiratory failure. No agent has been found to be highly effective in halting disease activity. Based on recent outcomes of stem cell transplant trials and reports in autoimmune diseases including MS, and based on the mechanisms of NMO, we anticipate that stem cell transplantation may provide lasting disease stability for NMO patients. The hypothesis of the present trial is that autologous hematopoetic stem cell transplantation in patients with NMO will provide lasting benefit in relapse prevention. Specifically, we anticipate a 50% reduction in the proportion of patients experiencing relapse over a three year period. We will be following patients for a total of five years after transplantation.
Detailed description
Patients who are deemed eligible will be enrolled and undergo a two stage transplant process followed by neurological assessments every 6 months for the following 5 years assessing EDSS, visual metrics, MRI, AQP-4 antibodies, MSFC and SF36.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| AHSCT | Experimental | Procedure: AHSCTAll patients undergo autologous hematopoietic stem cell transplantation in a two stage process. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Age between 18-65, inclusive
- Diagnosis of NMO using Wingerchuk 2006 NMO Criteria
- EDSS 0-6.5
- Treatment with a minimum of one NMO therapy in past 12 months
- One objective and documented relapse in the past 12 months and two relapse events in the past 24 months despite medical therapy
Key exclusion criteria (13 listed)
- Any illness that would jeopardize the ability of the patient to complete study protocol
- Prior malignancy unless non-melanoma skin cancer, carcinoma in-situ of the cervix (CIN) or breast, or malignancy treated more than 5 years previously with no evidence of recurrent disease since initial treatment
- Pregnant or lactating females. Women of childbearing potential must have a negative serum or urine β-hCG pregnancy test at screening
- Inability or unwillingness to pursue effective means of birth control
- FEV1/FVC < 50% of predicted
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AHSCTAHSCT Procedure: 1. Mobilization and Harvesting: * Cyclophosphamide * Rituximab * GSCF * Dexamethasone * Apheresis 2. Conditioning and Infusion (3-4 weeks after Mobilization and Harvesting): * Cyclophosphamide * MESNA * Rabbit ATG * Rituximab * Methylprednisolone * Stem Cell infusion * GSCF | Procedure or surgery | AHSCT |
Primary outcome
Proportion relapse-free at three years
Time frame: 3 years
The proportion of surviving patients who are relapse-free at three years after transplant
9 secondary outcomes
Proportion relapse-free at five years
Time frame: 5 years
Relapse count
Time frame: Annually over 5 years
Disability progression
Time frame: Over 5 years
Retinal nerve fiber layer (RFNL) status
Time frame: 5 years
25 foot timed walk test
Time frame: 5 years
PASAT
Time frame: Annually over 5 years
Hospitalization
Time frame: Over 5 years
Overall survival
Time frame: Over 5 years
Time to next relapse
Time frame: Over 5 years
Results and safety
The study was stopped early (reason given: recruitment failure). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 May 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jodie M Burton, MD,MSc,FRCPC principal investigator
Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary
Jan Storek, MD,PhD principal investigator
Department of Medicine, University of Calgary
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing AHSCT in people with Neuromyelitis Optica, run by University of Calgary at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 2 May 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: recruitment failure). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion relapse-free at three years (time frame: 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 May 2018.